Book Review | Published:

Book Review: Dental Fear and Anxiety in Paediatric Patients

BDJ volume 224, page 298 (09 March 2018) | Download Citation


 Springer, 2017  price £108 pp. 252  ISBN 9783319487274

This book provides a practitioner's guide to navigating the often daunting world of dental fear and anxiety (DFA) in children. It is aimed at practitioners of all levels as a practical guide to recognising and managing DFA in order to achieve better outcomes for the child, the parent and the practitioner. As a recently graduated associate, I can appreciate the value of this book for all clinicians, from undergraduates to GDPs, and I am sure this would be a vital resource for clinicians pursuing specialist training. Dr Campbell has collated a varied range of esteemed contributors who each share their wisdom and experience. They cover the aetiology and presentations of DFA, the assessment process, and the range of management options and techniques. A common theme noted throughout the publication is the importance of planning and the emphasis is on involving the child wholly at each stage of treatment. Throughout each section, the reader is equipped with theoretical and practical skills and tips. The book is punctuated with helpful diagrams and information summarised in tables. Chapters end with summary 'key points' in highlighted sections and case-based scenarios, which allow for a deeper understanding of the theory covered previously and an idea of practical application.

The book is split into three main parts with sub-chapters, in a logical sequence, which makes for easy reference if looking for a specific topic. Each chapter is interspersed with relevant information from previous topics to allow a slick flow through each section.

Section one is centred on background and assessment; the 'why', in order for the dentist to develop empathy and to understand why the patient is anxious. In order to tailor their care, a patient-centred approach is paramount. This section guides the clinician through the different coping styles of patients, why this information is important, and how to plan for and carry out an assessment visit. It then offers practical advice on treatment allocation and how to explain this to the parent and patient.

Section two focuses on actual treatment. There is an in-depth discussion of non-pharmacological options to help patients cope with DFA and accept treatment. The chapter also covers appropriate language to use, words to avoid and some suggestions given by children themselves. This highlights the relevance of the book regarding the subject demographic. Links to previous chapters throughout this section make the book an ideal quick-reference guide if required. Particularly of note, the section on hypnosis gives an appointment-by-appointment table and layout for the clinician to feel prepared and to deliver this well. The section moves on to pharmacological management, including intravenous sedation and coping with local anaesthetic. Again, there is a useful table covering the range of techniques so the appropriate one may be selected. The section finishes with a discussion of cognitive behavioural therapy (CBT) in both adults and children, and its application.

Section three discusses 'Moving Forward' for the dentally anxious child. This is heavily interlinked with 'the voice of the child', the wants and needs of the child/young person. It summarises the different care pathways available and outlines when each of these may be suitable in order to achieve proportionate child centred dental care. Again, this is available in a user friendly diagram.

From my personal experience, I would absolutely recommend this book to any clinician treating children/young people with dental fear/anxiety. Actually, any of the principles can also be adapted for use on adults, and certainly section one can help the clinician to understand the aetiology in order to treat patients more empathetically. The layout of the book is wonderfully accessible – each section links well with the last, with relevant information being brought forward making for a quick-reference guide – meaning it's easy to refresh one's memory on a particular topic before the patient comes in! In summary, this book gives a comprehensive but succinct coverage of the subject matter and makes for an essential resource for anyone who treats those with dental fear/anxiety. It will help those interested in improving their management of this cohort of patients, thus leading to better outcomes for patients, parents and clinicians.

Personally, this text has sparked an interest in hypnosis, which I hope to integrate into my practice and pursue further in order to enhance my management of anxious patients.

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